The Rational Clinical Examination
David L. Simel, Drummond Rennie
Murmur, Diastolic
Niteesh K. Choudhry, Edward E. Etchells
An OS is a high-frequency, early-diastolic sound that is associated with the opening of a...
Topics Discussed:
aortic valve insufficiency, austin flint murmur, diagnostic process, diastolic murmur, heart auscultation, heart sounds, mitral valve stenosis, pulmonary valve insufficiency, pulse pressure
Excerpt:
"Aortic regurgitation is a potentially serious cardiac abnormality
that may be caused by important underlying disorders. Patients with
AR require careful clinical monitoring to identify the optimal time
for surgical intervention. Asymptomatic patients with severe AR
may benefit from vasodilator therapy.1The cardinal manifestation of AR is a diastolic murmur. Diastolic
murmurs are important indicators of structural cardiac abnormalities
or pathologic states of increased flow (Table
32-1). As discussed in a previous article in this series,3 heart
murmurs are produced when turbulent blood flow causes prolonged
auditory vibrations of cardiac structures. The intensity of the
murmur depends on many factors, including blood viscosity, blood
flow velocity and turbulence, the distance between the vibrations
and the stethoscope, the angle at which the vibrations meet the
stethoscope, the transmission qualities of the tissue between the
vibration and the stethoscope, and the auditory skills of the examiner.4..."
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